Supply of 220 KV XLPE cable along with termination module & accessories including laying and termination at POWERGRID 400/220 kV Raipur substation

Quantity in km.

Type Tests

Fill up only green shaded cells in Sch-1, Sch-2, Sch-3 & Discount.

All the cells in Sch-5 are auto filled, therefore no cell is required to be filled up there.

The price quoted in respect of all items shall be excluding GST applicable on transaction between the Employer and the Contractor

Manufacturer

Authorized Representative of Manufacturer

Contract & Material

Power Grid Corporation of India Ltd.,

Western Region -I Headquarters

Item No.

Printed Name :

Designation :

Schedule - 2

Contract & Material

Power Grid Corporation of India Ltd.,

Western Region -I Headquarters

Item no.

Local Transportation, In-transit Insurance, Loading and Unloading

Printed Name :

Designation :

Contract & Material

Power Grid Corporation of India Ltd.,

Western Region -I Headquarters

ITEM NO.

All kinds of soil

Pipes, cables etc. exceeding 80mm dia but not exceeding 300mm dia.

1:4:8 (1 Cement : 4 coarse sand : 8 graded stone aggregate 40 mm nominal size)

Foundations, footings, bases for columns

100 mm dia

Sand cast iron S&S pipe as per IS: 1729

150 mm dia pipe

150 mm diameter pipe

150mm diameter

150 mm diameter S.W. pipe

300 mm dia RCC pipes.

With 20x20 mm square bar

Printed Name :

Designation :

Schedule - 2

Contract & Material

Power Grid Corporation of India Ltd.,

Western Region -I Headquarters

Item no.

NON-SCHEDULE ITEMS

With Fly Ash Bricks

Meter

Designation :

Schedule - 3

As per Lum-sum

AS per Percent

Contract & Material

Power Grid Corporation of India Ltd.,

Western Region -I Headquarters

Activity Number

Schedule - 5

Contract & Material

Power Grid Corporation of India Ltd.,

Western Region -I Headquarters

Description

PART-A- Ex-Works Supply

PART-B- F&I

PART-C- Installation including Cicil Works

Printed Name :

Schedule - 5 After Discount

Contract & Material

Power Grid Corporation of India Ltd.,

Western Region -I Headquarters

Description

PART-A- Supply Excl GST

PART-C- Service Excl GSt

GRAND TOTAL after Discount ( Excl GST )

add GST @ 18% on PARt-A

included

GRAND TOTAL after Discount : Part: A+B+C ( Including GST)

Printed Name :

Designation :

Letter of Discount

Supply of 220 KV XLPE cable along with termination module & accessories including laying and termination at POWERGRID 400/220 kV Raipur substation

Eq Weightage of Rs/ %

Discount on lum-sum basis on total price quoted by us. [The discount shall be proportionately applicable on all the items of all the Schdules of all the Parts i.e. (PART-A + Part-B+PART-C) In Rs.

Discount on percent basis on total price quoted by us. [The discount shall be proportionately applicable on all the items of all the Schdulesof all the Parts i.e. (PART-A + Part-B+PART-C) In Percent (%)

We hereby offer Multi-package discount as given below:

Printed Name :

Designation :

Supply of 220 KV XLPE cable along with termination module & accessories including laying and termination at POWERGRID 400/220 kV Raipur substation

In continuation of First Envelope of our Bid, we hereby submit the Second Envelope of the Bid, both of which shall be read together and in conjunction with each other, and shall be construed as an integral part of our Bid. Accordingly, we the undersigned, offer to execute the work of Supply of 220 KV XLPE cable along with termination module & accessories including laying and termination at POWERGRID 400/220 kV Raipur substation under the above-named package in full conformity with the said Bidding Documents for the sum of Rs. 0 (Rupees only) or such other sums as may be determined in accordance with the terms and conditions of the Bidding Documents.

Price Schedules

In line with the requirements of the Bidding documents, we enclose herewith the following Price Schedules, duly filled - in as per your proforma:

PART-A-Ex-Works Supply

PART-B-F&I

PART-C-Installation including Civil Works

GRAND SUMMARY

GRAND SUMMARY after DISCOUNT

We are aware that the Price Schedules do not generally give a full description of the Work to be performed under each item and we shall be deemed to have read the Technical Specifications and other sections of the Bidding Documents and Drawings to ascertain the full scope of Work included in each item while filling-in the rates and prices. We agree that the entered rates and prices shall be deemed to include for the full scope as aforesaid, including overheads and profit.

We declare that as specified in Clause 11.5, Section –II:ITB, Vol.-I of the Bidding Documents, prices quoted by us in the Price Schedules in Second Envelope shall be subject to Price Adjustment during the execution of Contract in accordance with Appendix-2 (Price Adjustment) to the Contract Agreement.

We understand that in the price schedules, where there are errors between the total of the amounts given under the column for the price Breakdown and the amount given under the Total Price, the former shall prevail and the latter will be corrected accordingly. We further understand that where there are discrepancies between amounts stated in figures and amounts stated in words, the amount stated in words shall prevail. Similarly, any discrepancy in the total bid price and that of the summation of Schedule price (price indicated in a Schedule indicating the total of that schedule), the total bid price shall be corrected to reflect the actual summation of the Schedule prices.

We declare that items left blank in the Schedules will be deemed to have been included in other items. The TOTAL for each Schedule and the TOTAL of Grand Summary shall be deemed to be the total price for executing the Facilities and sections thereof in complete accordance with the Contract, whether or not each individual item has been priced.

We, hereby, declare that only the persons or firms interested in this proposal as principals are named here and that no other persons or firms other than those mentioned herein have any interest in this proposal or in the Contract to be entered into, if the award is made on us, that this proposal is made without any connection with any other person, firm or party likewise submitting a proposal is in all respects for and in good faith, without collusion or fraud.

Printed Name :

Designation :

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Supply of 220 KV XLPE cable along with termination module & accessories including laying and termination at POWERGRID 400/220 kV Raipur substation

WR1/NT/W-CABLE/DOM/F01/26/08125 (RFx No. 5002005451)

WR1/NT/W-CABLE/DOM/F01/26/08125 (RFx No. 5002005451)

6 Months

General guidelines for filling up the Attachments

Fill up only green shaded cells in the relevent attachments.

Attachments 3(JV), 4, 4(A), 4(B), 5, 5(A), 6, 7, 9, 10, 11, 12, 13, 14, 15, 16, 17,18, 19 and Bid Form for 1st Envelope are included here.

Attachment 1 Bid Security : To be submitted as perproforma provided in the bidding document.

Attachment 2 Power of Attorney : No specific format is provided by POWERGRID. Bidder may use their own format.

Attachment 8 Manufacturer’s Authorisation Form : To be furnished as per proforma provided in the bidding document, on the letter head of the each Manufactures proposed to supply main items. Not included here.

Attachment 14 Integrity Pact : To be submitted as per ITB Clause No. 9.3(n) and as per remarks in the Attach 14-IP.

Attachment 18 Safety Pact : To be submitted as per ITB Clause No. 9.3(r) and as per remarks in the Attach 18 SP.

Attachment-3(QR), Attachment 20, Attachment-21, Attachment-22, Attachment-23, Attachment-24, Attachment-25, Attachment-26, Attachment-27, Attachment-28, Attachment-29 & Attachment-30: To be submitted as per the provisions of the Bidding Documents ( Formats Attached seperately in Volume-III of Bidding Documents)

Enable the Active X Control & Macros. Also ensure to keep option of "Trust acess to VBA project object Model" cheched [√]. Ensure that you work on MS Excel 2007 or higher version.

Sole Bidder

JV (Joint Venture)

Sole Bidder

Joint venture Route

Attachment-3(JV)

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Sole Bidder

Designation :

Attachment-3(QR)

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Designation :

Attachment-4

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Equipments & Materials produced in [Name of countries]

[Name of Countries]

Designation :

country.

Attachment-4(A)

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

For Equipment

Designation :

Attachment-4(B)

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Designation :

Attachment-5

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Item Description

Nationality

FALSE

Item Description

Address

Designation :

Annexure I to Attachment-5

Item Description

Nationality

Designation :

Annexure I to Attachment-5

Item Description

Nationality

Designation :

Attachment-5A

Contract Services

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I, Regional Head Quarters, Sampriti Nagar, P.O.: Uppalwadi, Nagpur – 440 026, Maharashtra

We hereby furnish the details of the items, components, raw material, services which we propose to buy/avail from Micro and Small Enterprises (MSEs) for the purpose of completion of works under the subject package:

Item Description

Category (Micro or Small)

FALSE

The above is a list of items we propose to procure from MSEs. However, based on the situations during the execution of the contract, the above list may undergo changes. We hereby confirm that the details regarding actual procurement from MSEs carried out by us, as per the format provided at Section VI, Forms and Procedures, Volume-I of bidding documents, shall be submitted along with the bills for payment against supplies made/works done during execution of contract.

Item Description

Address

Designation :

Attachment-5A

Item Description

Category (Micro or Small)

Designation :

Attachment-6

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Reference clause in the Specifications

Designation :

Annexure I toAttachment-6

Reference clause in the Specifications

Designation :

Attachment-7

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Designation :

Attachment-9

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Description of Work

Detailed Engineering and drawing submission

Procurement of equipment/ components & assembly

Type Tests

Manufacturing

Shipments & Delivery

Establishment of site office

Installation at Site

Testing & Pre-commissioning

Trial Operation

Designation :

Bidders to enclose a detailed network covering all the activities to be undertaken for completion of the project indicating key dates for various milestones for each phase constituent-wise.

Attachment-10

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Designation :

Attachment-11

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Name of the person with designation in POWERGRID

Designation :

ATTACHMENT-12

Contract Services

Power Grid Corporation of India Ltd.,

SCO Bay 5-10, near Haryana Pollution Control board Office,

Name of Materials/Labour

XLPE Cable

XLPE Compound, a=

Published Price of Metal

Aluminum (per MT)

Copper (per MT)

Weight in MT of Metal per km (size wise)

Designation :

Attachment-13

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Designation :

Attachment-14

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Designation :

The requisite format of Integrity Pact is getting generated automatically and displayed here below.

Take print out of first page on a non-judicial stamp paper of Rs. 100/- and other seven pages on plain A4 size paper. Such two sets shall be prepared by the bidder.

All the pages of both the copies of the Integrity Pact shall be signed by the authorised representative of the bidder and duly stamped.

Both the original copies shall be submitted by the bidder in the form of Hard Copy as part of the first envelope before due date & time of submission of the bid.

For further details bidders may please refer ITB Clause 9.3 (o).

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 1 of 8

POWERGRID commits itself to take all measures necessary to prevent corruption and to observe the following principles :

No employee of POWERGRID, personally or through family members, will in connection with the tender, or the execution of the contract, demand, take a promise for or accept, for him/herself or third person, any material or other benefit which he/she is not legally entitled to.

POWERGRID will, during the tender process treat all Bidder(s) with equity, fairness and reason. POWERGRID will in particular, before and during the tender process, provide to all Bidder(s) the same information and will not provide to any Bidder(s) confidential/ additional information through which the Bidder(s) could obtain an advantage in relation to the tender process or the contract execution.

POWERGRID will exclude from evaluation of Bids its such employee(s) who has any personal interest in the Companies/Agencies participating in the Bidding/Tendering process and all known prejudiced persons.

If POWERGRID obtains information on the conduct of any of its employee which is a criminal offence under the IPC / PC Act , or if there be a substantive suspicion in this regard, POWERGRID will inform its Chief Vigilance Officer and in addition disciplinary actions can be initiated under POWERGRID’s Rules.

The Bidder/Contractor commits itself to take all measures necessary to prevent corruption. The Bidder/Contractor commits itself to observe the following principles during its participation in the tender process and during the contract execution:

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 2 of 8

The Bidder/Contractor will not, directly or through any other person or firm, offer, promise or give to any of POWERGRID's employees involved in the tender process or the execution of the contract or to any third person any material or other benefit which it is not legally entitled to, in order to obtain in exchange an advantage of any kind whatsoever during the tender process or during the execution of the contract.

The Bidder/Contractor will not enter into any illegal or undisclosed agreement or understanding, whether formal or informal with other Bidders/Contractors. This applies in particular to prices, specifications, certifications, subsidiary contracts, submission or non-submission of bids or actions to restrict competitiveness or to introduce cartelization in the bidding process.

The Bidder/Contractor shall not pass any information provided by POWERGRID as part of business relationship to others and shall not commit any offence under PC / IPC Act.

The Bidder/Contractor of foreign origin shall disclose the name and address of the Agents/representatives in India, if any, involved directly or indirectly in the Bidding. Similarly, the Bidder/Contractor of Indian Nationality shall furnish the name and address of the foreign principals, if any, involved directly or indirectly in the Bidding.

The Bidder/Contractor will, when presenting his bid, disclose any and all payments made, or committed to or intends to make to agents, brokers or any other intermediaries in connection with the award of the contract and/or with the execution of the contract.

The Bidder/Contractor will not misrepresent facts or furnish false/forged documents/information in order to influence the bidding process or the execution of the contract to the detriment of POWERGRID.

The Bidder/Contractor shall ensure adoption of Integrity Pact by its Sub-contractors and shall be responsible for the same.

The Bidder/Contractor will not instigate third persons to commit offences outlined above or be an accessory to such offences.

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 3 of 8

If the Bidder, before contract award, has committed a transgression through a violation of Section II or in any other form such as to put his reliability or credibility as Bidder into question, POWERGRID may disqualify the Bidder from the tender process or terminate the contract, if already signed, for such reason.

If the Bidder/Contractor has committed a transgression through a violation of Section II such as to put his reliability or credibility into question, POWERGRID may, after following due procedures, ban /blacklist the Bidder/Contractor in line with POWERGRID’s policy for “Black-Listing of Firms / Banning of Business”. The imposition and duration of the ban will be determined by the severity of the transgression. The severity will be determined by the circumstances of the case, in particular the number of transgressions, the position of the transgressors within the company hierarchy of the Bidder/Contractor and the amount of the damage. The ban will be imposed for a maximum of 3 years.

If the Bidder/Contractor can prove that he has restored/recouped the damage caused by him and has installed a suitable corruption prevention system, POWERGRID may revoke the ban prematurely.

If POWERGRID has disqualified the Bidder from the tender process prior to the award under Section III, POWERGRID is entitled for forfeiture of the Bid Guarantee under the Bid.

If POWERGRID has terminated the contract under Section III or if POWERGRID is entitled to terminate the contract under Section III, POWERGRID shall be entitled to forfeit the Contract Performance Guarantee of this contract, in full or part thereof as may be decided, besides resorting to other remedies under the contract.

The Bidder shall disclose in its Bid any transgressions occurred in the last 10 years with any other Public Sector Undertaking or Government Department or any other Company, in any country, that may impinge on the Anti-corruption principle.

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 4 of 8

If the Bidder makes incorrect statement on this subject, it can be disqualified from the tender process or the contract, if already awarded, can be terminated for such reason and further action can be taken in line with POWERGRID’s policies.

POWERGRID will enter into agreements with identical conditions as this one with all Bidders.

POWERGRID will disqualify from the tender process any bidder who does not sign this Pact or violate its provisions.

POWERGRID has appointed a panel of Independent External Monitors (IEMs) for this Pact with the approval of Central Vigilance Commission (CVC), Government of India. The names of the IEMs have been indicated in the Bidding Documents.

The panel of IEMs shall review independently and objectively, whether and to what extent the parties comply with the obligations under this agreement. The panel of IEMs has right of access to all project documentation. The panel of IEMs may examine any complaint received by them and submit a report to Chairman-cum-Managing Director, POWERGRID, giving joint findings, at the earliest. The panel of IEMs may also submit a report directly to the CVO and the CVC, in case of suspicion of serious irregularities attracting the provisions of the PC Act.

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 5 of 8

The IEM is not subject to instructions by the representatives of the parties and performs his functions neutrally and independently. He / She reports to the Chairman-cum-Managing Director, POWERGRID.

The Bidder(s)/Contractor(s) accepts that the IEM has the right to access without restriction to all documentation of POWERGRID related to this contract including that provided by the Contractor/Bidder. The Bidder/Contractor will also grant the IEM, upon his / her request and demonstration of a valid interest, unrestricted and unconditional access to their documentation. The same is applicable to Subcontractors. The IEM is under contractual obligation to treat the information and documents of the Bidder(s)/Contractor(s)/Subcontractor(s) with confidentiality.

POWERGRID will provide to the IEMs information as sought by him / her which could have an impact on the contractual relations between POWERGRID and the Bidder/Contractor related to this contract. The IEMs shall also sign declaration on ’Non-Disclosure of Confidential Information’ and of ‘Absence of Conflict of Interest’. In case of any conflict of interest arising at a later date, the IEM shall inform Chairman-cum-Managing Director, POWERGRID and recuse himself/herself from that case

As soon as the IEM notices, or believes to notice, a violation of this agreement, he / she will so inform the Chairman-cum-Managing Director, POWERGRID and request the Chairman-cum-Managing Director, POWERGRID to discontinue or take corrective action, or to take other relevant action. The IEM can in this regard submit non-binding recommendations. Beyond this, the IEM has no right to demand from the parties that they act in a specific manner, refrain from action or tolerate action. However, the IEM shall give an opportunity to POWERGRID and the Bidder/Contractor, as deemed fit, to present its case before making its recommendations to POWERGRID.

The IEM will submit a written report to the Chairman-cum-Managing Director, POWERGRID within 8 to 10 weeks from the date of reference or intimation to him by POWERGRID and, should the occasion arise, submit proposals for correcting problematic situations.

If the IEM has reported to the Chairman-cum-Managing Director, POWERGRID, a substantiated suspicion of an offence under PC / IPC Act, and the Chairman-cum-Managing Director, POWERGRID has not, within the reasonable time taken visible action to proceed against such offence or reported it to the CVO, the Monitor may also transmit this information directly to the CVC, Government of India.

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 6 of 8

While representing any matter in relation to the Integrity pact inter-alia including its transgression to the panel of IEMs, POWERGRID and Bidder/Contractor shall not approach the court of law and await the decision of the IEM in the matter.

The word ‘IEM’ would include both singular and plural.

This Section shall be applicable for only those packages wherein the IEMs have been identified in Section – I : Invitation for Bids and/or Clause ITB 9.3 in Section – III: Bid Data Sheets of Conditions of Contract, Volume-I of the Bidding Documents.

This agreement is subject to Indian Law. Place of performance and jurisdiction is the establishment of POWERGRID. The Arbitration/Conciliation clause provided in the main tender document / contract shall not be applicable for any issue / dispute arising under Integrity Pact.

Changes and supplements as well as termination notices need to be made in writing. Side agreements have not been made.

If the Contractor is a partnership firm or a consortium or Joint Venture, this agreement must be signed by all partners, consortium members and Joint Venture partners.

Nothing in this agreement shall affect the rights of the parties available under the General Conditions of Contract (GCC) and Special Conditions of Contract (SCC).

Issues like Warranty/Guarantees etc. shall be outside the purview of IEMs.

Views expressed or suggestions/submissions made by the parties and the recommendations of the CVO/IEM# in respect of the violation of this agreement, shall not be relied on or introduced as evidence in the arbitral/conciliation or judicial proceedings (arising out of the arbitral/conciliation proceedings) by the parties in connection with the disputes/differences arising out of the subject contract.

CVO shall be applicable for packages wherein IEM are not identified in Section IFB/BDS of Condition of Contract, Volume-I. IEM shall be applicable for packages wherein IEM are identified in Section IFB/BDS of Condition of Contract, Volume-I.

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 7 of 8

Should one or several provisions of this agreement turn out to be invalid, the remainder of this agreement remains valid. In this case, the parties will strive to come to an agreement to their original intentions.

Signature

(For & On behalf of Bidder/ Contractor)

(Office Seal)

Designation :

Witness 1 :

Designation :

Witness 2 :

Designation :

Page 8 of 8

Attachment-15

Contract Services

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

We are furnishing the following details of Statutory Registration Numbers and details of Bank for electronic payment.

Name of the Supplier/ Contractor in whose favour payment is to be made

Address with PIN Code and State

Status – Company/others

Are you a MSE owned by SC/ST* entrepreneurs in line with Public Procurement Policy for Micro and Small Enterprises (MSEs) order 2012 including subsequent amendment /notification/order (Indicate Yes/No) Note: Documentary evidence is to be attached. Please refer remarks at the end of the Attachment.

If 3(b) is 'Yes', please mentiom whether you are (Proprietary MSE/ Partnership MSE/Private Limited Company) owned by SC/ST Entrepreneurs.

Are you a MSE owned by a women in line with Public Procurment Policy for Micro and Small Enterprises (MSEs) order 2012, Public Procurment Policy for Micro & Small Enterprises (MSEs) Amendment Order 2018 including subsequent amendment / notification/order . (Indicate Yes/No)

Permanent Account (PAN) No.

GSTIN Numbers

GSTIN in the Sates/UT from where the supply of goods take place

GSTIN number

GSTIN in the States/UT where the supply for services take place (states where sites under the subject package is situated)

GSTIN number

PF Registration No. of the Company

PF Regional Office covered (with Address)

Name of Contact Person

Contact Details

Bank Details for Electronic Payment

Current Account

9 digit MICR code printed at bottom in middle, next to cheque no.

IFSC (for RTGS)/NEFT Code (to be obtained from the Bank) Sample Cancelled Cheque to be enclosed

Designation :

Attachment-16

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

The Bidder shall furnish

In accordance with 1.0, certificate(s) from banker as per requisite format, indicating various fund based/non fund based limits sanctioned to the bidder or each member of the joint venture and the extent of utilization as on date is/are enclosed, as per the following details:

The Bidder should accordingly also provide the following information/documents

Details of Banker:

As per para 1.0, Authorization Letter(s) from the bidder (in case of JV bidder, from all the partners) addressed to the Banker(s), authorizing POWERGRID to seek queries about the bidder with the Banker(s) and advising the Banker(s) to reply the same promptly, is/are enclosed as per following details:

Letter Ref.

Litigation History

Details of litigation history resulting from Contracts completed or under execution by the bidder over the last five years

Name of client, cause of litigation/arbitration and matter in dispute

Details regarding previous transgressions of Integrity Pact

Details regarding previous transgressions of Integrity Pact that occurred in the last 10 years

Name of client

OTHER INFORMATION

Current Contract Commitments of works in progress

Value of outstanding work (Rs.)

Financial Data:

Actual (Previous five years)

Details of Provident Fund Code Number of the Bidder [ref. ITB9.3(q)]

Designation :

Attachment-17

Power Grid Corporation of India Ltd.,

SCO Bay 5-10, near Haryana Pollution Control board Office,

We confirm that we are solely responsible for obtaining following tax exemptions, reductions, allowances or benefits in respect of supplies under the subject package, in case of award. We further confirm that we have considered the same in our bid thereby passing on the benefit to POWERGRID while quoting our prices. In case of our failure to receive such benefits, partly or fully, for any reason whatsoever, the Employer will not compensate us.

We are furnishing the following information required by the Employer for issue of requisite certificate if and as permitted in terms of the applicable Govt. of India policies/procedures (in case of award):

Designation :

Attachment-17

Sector 16A, Faridabad, Haryana 121002

Name of the person with designation in POWERGRID

Designation :

Attachment-17

Power Grid Corporation of India Ltd.,

SCO Bay 5-10, near Haryana Pollution Control board Office,

Name of the person with designation in POWERGRID

Designation :

Attachment-18

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Designation :

The requisite format of Safety Pact is getting generated automatically and displayed here below.

Take print out of first page on a non-judicial stamp paper of Rs. 100/- and other six pages on plain A4 size paper. Such two sets shall be prepared by the bidder.

All the pages of both the copies of the Safety Pact shall be signed by the authorised representative of the bidder and duly stamped.

Both the original copies shall be submitted by the bidder in the form of Hard Copy as part of the first envelope before due date & time of submission of the bid.

For further details bidders may please refer ITB Clause 9.3 (s).

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 1 of 6

POWERGRID recognizes and accepts its statutory responsibilities for ensuring construction, operation and maintenance of equipments and for the provision of safe methods of work and safe working conditions.

POWERGRID recognizes and accepts its statutory responsibilities for ensuring safety of not only its employees but also that of the Contracting Agencies as Principal Employer.

POWERGRID shall review the accidents in a structured manner and take necessary actions to ensure that the safety criteria are strengthened for safe construction as well as Operation & Maintenance of the Transmission Assets.

POWERGRID shall conduct necessary awareness and training programmes to its Employees to augment the various safety requirements to be followed during Construction and Operation & Maintenance of the Transmission Assets from time to time.

POWERGRID shall, from time to time, issue necessary guidelines,instructions and deterrents to its employees as well as to the Contracting Agencies, to update them to take necessary preventive measures to avoid repetition of similar accident attributes.

POWERGRID shall review and provide necessary guidanceto the Contracting Agencies, as and when, any abnormality / special situations are brought to its notice by the Contracting Agencies during execution of the Transmission Projects being executed by them.

POWERGRID shall conduct periodical surveillance site inspections / audits to identify the unsafe conditions and unsafe actions, and bring them to the knowledge of the Contracting Agencies for taking timely corrective actions.

POWERGRIDshall investigate all accidents, fatal as well as non-fatal, to identify the lapses, the reason for the accident / incident and suggest measures for prevention of recurrence of such accidents, and fix responsibility for the lapses leading to the accident.

POWERGRID shall augment the training to the workers and supervising personnel of the Contracting Agencies, as per schedules, upon nomination by the Contracting Agencies in reasonable time frame.

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 2 of 6

POWERGRID shall exercise the right to claim and recover compensation from the Contracting Agencies in case of any violation of the safety requirements / provisions during execution of the Transmission Projects, as built in the applicable Laws and contractual specifications / guidelines in vogue / issued by POWERGRID from time to time.

The Bidder / Contractor recognizes and acceptsthe statutory and comprehensive responsibility for ensuring safe construction and Testing & Commissioning in the Transmission Projects being executed by them by providing safe methods of work, working conditions and Tools & Plants for human safety.

The Bidder / Contractor recognizes and accepts the responsibilities for ensuring safety of not only their employees but also that of the Sub-contractors, Principal Employer and the general public during execution of the Transmission Projects / works.

The Bidder / Contractor shall review the accidents in a structured manner and take necessary actions to ensure that the safety criteria are strengthened for safe construction of the Transmission Assets.

The Bidder / Contractor shall endeavour continuous development of safe methods of work to ensure that the effect of risks and perils are minimised to the extent possible and implement the same at their worksites.

The Bidder / Contractor shall conduct periodical Training to their Employees as well as to that of their Sub-contractors for safety awareness during construction works being executed by them.

The Bidder / Contractor shall provide all requisite Tools & Plants required for the work and ensure their healthiness by periodical inspections / testing as required. Unhealthy and sub-standard Tools & Plants will be immediately removed from site as and when they are identified.

The Bidder / Contractor shall,at their cost, provide all necessary Personal Protective Equipments such as Double Lanyard Safety Belts, Appropriate Fall Arrest Systems, Safety Helmets, Foot Wear, Hand Gloves, etc., as required for various activities pertaining to execution of the Projects / works, confirming to relevant Indian Standards.

The Bidder / Contractor shall ensure that dedicated qualified Safety Officers are posted in the construction projects being executed by them and ensure that the Safety Officer visits each and every gang periodically and conducts audits / inspections to identify the unsafe conditions and unsafe actions, to be rectified by the site supervising personnel promptly.

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 3 of 6

The Bidder / Contractor shall conduct appropriate medical checks-up for the workers before deploying them at their construction sites to ensure that only those who are medically fit are deployed in the Projects / works to be executed by them. The copy of the Medical Reports shall be provided by the Bidder / Contractor to POWERGRID, whenever requested by POWERGRID.

The Bidder / Contractor shall screen the workers before deploying them at their construction sites to ensure that only those with the skills, experience and competence to work at height and also medically fit for work at height are deployed for work at height in the Projects executed by them.

The Bidder / Contractor shall ensure daily before starting the work that their site Supervising Personnel / Safety Officer briefs the workers about the work for the day and the safety measures / precautions required to be taken by them.

The Bidder / Contractor shall investigate all the accidents at their working sites to ascertain the lapses leading to the incident and the precautionary / corrective measures required to be taken to avoid recurrence of such accidents. These accidents will be reviewed at the Board Management level of the Agencies and the findings / recommendations will be put up to POWERGRID Apex Safety Board within the stipulated period.

The Bidder / Contractor shall ensure that all accidents, whether fatal or non-fatal in nature, will be informed to POWERGRID, in writing, immediately on the occurrence of the same,and in any case, within not more than 24 hours of occurrence of the same.

The Bidder / Contractor shall ensure that in case of any accident, all necessary medical help / support shall be provided to the victims / injured till they are completely fit to return to work.

The Bidder / Contractor shall ensure that in case of fatal accidents, all statutory Authorities, including Police, concerned Labour Dept. Officials, concerned Workmen Compensation Commissioner, etc., will be intimated in writing as required by the statutory Law, and followed up for compliance of all statutory obligations. The Bidder / Contractor shall own full responsibility of timely accident reporting to various authorities, including POWERGRID.

The Bidder / Contractor shall ensure that in case of fatality or serious injury leading to permanent disablement of the victims, the compensation amount will be deposited with the concerned authorities, as required by the Laws, and followed up for early disbursement to the beneficiaries of the victims.

The Bidder / Contractor assures that they shall co-operate to the fullest extent for carrying out any investigation of the accidents at their work sites by POWERGRID to identify the lapses, the reason for the accident / incident and suggest measures for prevention of recurrence of such accidents. All factual details of the occurrence of the accident will be provided to POWERGRID, as and when required.

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 4 of 6

The Bidder / Contractor assures that they take full responsibility of meeting the statutory obligations in case of accidents, and in case of any reference by any Statutory Body at a later date also, they shall provide all information to POWERGRID and meet all the statutory obligations, including payment of additional compensation, if any.

The Bidder / Contractor assures that in case of any inspection of their work site or Notice by any Statutory Authority, they shall comply promptly and inform POWERGRID Site Officials of the same, and also provide all necessary information and assistance for smooth compliance of the observations / instructions of such Authorities.

The Bidder / Contractor accepts the provisions regarding safety, including payment of any sums to POWERGRID, in case of any violation of the safety requirements / provisions during execution of the Transmission Projects, as built in the Contractual Conditions, Safety Planand the Safety Pact, and confirm to abide by the same.

POWERGRID will enter into agreements with identical conditions as this one with all Bidders.

POWERGRID will disqualify, from the tender process, any bidder/ take punitive actions on the bidder, who does not sign this Pact or violate its provisions.

This agreement is subject to Indian Law. Place of performance and jurisdiction is the establishment of POWERGRID. The Arbitration/Conciliation clause provided in the main tender document / contract shall not be applicable for any issue / dispute arising under the Safety Pact.

Changes and supplements need to be made in writing, which shall come into force only upon mutual agreement / acceptance.

If the Contractor is a partnership firm or consortium of Joint Venture, this agreement must be signed by all partners, consortium members and Joint Venue partners, as applicable as per the Tender Specifications.

Nothing in this agreement shall affect the rights of the parties available under General Conditions of Contract (GCC) and Special Conditions of Contract (SCC).

Should one or several provisions of this agreement turn out to be invalid, the reminder of this agreement remains valid. In this case, the parties will strive to come to an agreement to their original intentions.

(Signature)

(For & On behalf of Bidder/ Contractor)

Page 5 of 6

Signature

(For & On behalf of Bidder/ Contractor)

(Office Seal)

Designation :

Witness 1 :

Designation :

Witness 2 :

Designation :

Page 6 of 6

Attachment-19

Power Grid Corporation of India Ltd.,

Western Region Transmission System - I,

Designation :

Bid Form 1st Envelope

thirteen

fourteen

Supply of 220 KV XLPE cable along with termination module & accessories including laying and termination at POWERGRID 400/220 kV Raipur substation

Enter details here.

Having examined the Bidding Documents, including Amendment Nos. ...[Enter the Amendment]… dated …[Enter the Date in dd-mm-yyyy]… the receipt of which is hereby acknowledged, we the undersigned, offer to design, manufacture, test, deliver, install and commission (including carrying out Trial operation, Performance & Guarantee Test as per the provision of Technical Specification) the Facilities under the above-named package in full conformity with the said Bidding Documents. In accordance with ITB Clause 9.1 of the Bidding Documents, as per which the bid shall be submitted by the bidder under “Single Stage - Two Envelope” procedure of bidding. Accordingly, we hereby submit our Bid, in two envelopes i.e. First Envelope – Techno – Commercial Part & Second Envelope - Price Part (to be opened subsequently).

We meet the eligibility requirements and have no conflict of interest in accordance with ITB Clause 2.

Attachments to the Bid Form (First Envelope)

Enter details here.

Not Applicable

A power of attorney duly authorized by a Notary Public indicating that the person(s) signing the bid have the authority to sign the bid and thus that the bid is binding upon us during the full period of its validity in accordance with the ITB Clause 14.

The documentary evidence that we are eligible to bid in accordance with ITB Clause 2. Further, in terms of ITB Clause 9.3 (c) & (e), the qualification data has been furnished as per your format enclosed with the bidding documents Attachment-3(QR).

The documentary evidence establishing in accordance with ITB Clause 3, Vol.-I of the Bidding Documents that the facilities offered by us are eligible facilities and conform to the Bidding Documents has been furnished as Attachment 4. A list of Special Tools & Tackles to be used by us for erection, testing & Commissioning and to be handed over to Employer, the cost of which is included is our Bid Price, is also enclosed as per your format as Attachment 4A. A list of Special Tools & Tackles to be brought by the contractor for erection, testing & Commissioning and to be taken back after completion of work, whose cost in not included in our bid price, is enclosed as per your format as Attachment 4B.

The details of all major items of services or supply which we propose subletting in case of award, giving details of the name and nationality of the proposed subcontractor/sub-vendor for each item.

Items, Components, Raw Material, Services proposed to be sourced from Micro and Small Enterprises

The variation and deviations from the requirements of the Conditions of Contract, Technical Specification and Drawings (excluding critical provisions as mentioned at clause 6.0 below) in your format enclosed with the Bidding Documents, including, inter alia, the cost of withdrawal of the variations and deviations indicated therein.

The details of Alternative Bids made by us indicating the complete Technical Specifications and the deviation to contractual and commercial conditions. (Not Applicable)

Manufacturer’s Authorisation Forms.

Work Completion Schedule.

Guarantee Declaration.

Information regarding ex-employees of Employer in our firm.

Filled up information regarding Price Adjustment Data as per the format enclosed in the bidding documents.

Declaration regarding Social Accountability.

Integrity Pact, in a separate envelope, duly signed on each page by the person signing the bid.

Option for Interest Bearing Advance(s) (Initial Advance and/or Engineering Advance) and Information for E – payment, PF details and declaration for Micro/Small and Medium Enterprise

Additional Information.

Declaration for tax exemptions, reductions, allowances or benefits

Safety Pact (Not Applicable)

Declaration.

Declaration of Key Managerial Person jointly with Power of Attorney holder

Affidavit of Self certification regarding Minimum Local Content in line with PPP-MII Order and MoP Order, if applicable

Certificate from statutory auditor or cost auditor of the company (in the case of companies) or from a practicing cost accountant or practicing chartered accountant (in respect of suppliers other than companies) giving the percentage of Local Content, in line with PPP-MII Order and MoP Order, if applicable

Certification by the Bidder as per DoE Order in line with ITB Clause 2.1

Declaration by the Bidder regarding events encountered pursuant to ITB Clause 2.1 Certification by the Bidder as per DoE Order in line with ITB Clause 2.1

Declaration by the bidder for ‘Code of Integrity for Public procurement’

Compliance to the process related to the e-RA Terms & Conditions and the Business Rules governing the e-RA.

Bid Securing Declaration to be submitted by the Bidder

Undertaking regarding submission of original/Hard copy part of the bid

Declaration for Acknowledgement and Acceptance of Supplier Code of Conduct

We are aware that, in line with Clause No. 27.1 (ITB), our Second Envelope (Price Part) is liable to be rejected in case the same contains any deviation/omission from the contractual and commercial conditions and technical Specifications other than those identified in this First Envelope.

We are aware that the Price Schedules do not generally give a full description of the Work to be performed under each item and we shall be deemed to have read the Technical Specifications and other sections of the Bidding Documents and Drawings to ascertain the full scope of Work included in each item while filling-in the rates and prices in Second Envelope.

We declare that as specified in Clause 11.5, Section –II:ITB, Vol.-I of the Bidding Documents, prices quoted by us in the Price Schedules in Second Envelope shall as per Appendix-I to Contract Agreement

We confirm that except as otherwise specifically provided our Bid Prices in Second Envelope include all taxes, duties, levies and charges as may be assessed on us, our Sub-Contractor/Sub-Vendor or their employees by all municipal, state or national government authorities in connection with the Facilities, in and outside of India.

100% of applicable Taxes and Duties i.e. GST, which are payable by the Employer under the Contract, shall be reimbursed by the Employer on production of satisfactory documentary evidence by the Contractor in accordance with the provisions of the Bidding Documents.

We further understand that notwithstanding 4.0 above, in case of award on us, you shall also bear and pay/reimburse to us, GST in respect of supplies by us to you, imposed on the Plant & Equipment including Mandatory Spare Parts to be incorporated into the Facilities including Type Test charges for Type test to be conducted specified in Schedule No. 1, Installation Services specified in Schedule No. 3 and Charges for Training to be imparted specified in Schedule No. 4 of the Price Schedule in Second Envelope; by the Indian Laws.

We confirm that we have also registered/we shall also get registered in the GST Network with a GSTIN, in all the states where the project is located and the states from which we shall make our supply of goods.

Construction of the Contract

We declare that we have studied Clause GCC 2.1 relating to mode of contracting for Domestic Bidders and we are making this proposal with a stipulation that you shall award us two separate Contracts viz ‘First Contract’ for ex-works supply of all equipment and materials including mandatory spares and ‘Second Contract’ for providing all the services i.e. inland transportation for delivery at site, In-transit insurance, unloading, handling at site, installation, testing and commissioning including Trial operation in respect of all the equipment supplied under the ‘First Contract’ and other services specified in the Contract Documents. We declare that the award of two contracts, will not, in any way, dilute our responsibility for successful operation of plant/equipment and fulfillment of all obligations as per Bidding Documents and that both the Contracts will have a cross-fall breach clause i.e. a breach in one Contract will automatically be classified as a breach of the other contract which will confer on you the right to terminate the other contract at our risk and cost.

We have read the provisions of following clauses and confirm that the specified stipulations of these clauses are acceptable to us:

Appendix 2 to Form of Contract Agreement

We undertake, if our bid is accepted, to commence the work immediately upon your Notification of Award to us, and to achieve the delivery of goods and related services within the time stated in the Bidding Documents.

If our bid is accepted, we undertake to provide a Performance Security in the form and amounts, and within the times specified in the Bidding Documents.

We agree to abide by this bid for a period of six (06) months from the date fixed for opening of bids as stipulated in the Bidding Documents, and it shall remain binding upon us and may be accepted by you at any time before the expiration of that period.

Until a formal Contract is prepared and executed between us, this bid, together with your written acceptance thereof in the form of your Notification of Award shall constitute a binding contract between us.

We understand that you are not bound to accept the lowest or any bid you may receive.

# (For Joint Venture only) We, the partners of Joint Venture submitting this bid, do agree and confirm that in case of Award of Contract on the Joint Venture, we shall be jointly and severally liable and responsible for the execution of the Contract in accordance with Contract terms and conditions.

We are a Micro and Small Enterprise (MSE) registered with , a designated Authority of GoI under the Public Procurement Policy for MSEs order 2012, Notification dated 01/06/2020 read in conjuction with related notifications issued from time to time for such enterprises.

We, hereby, declare that only the persons or firms interested in this proposal as principals are named here and that no other persons or firms other than those mentioned herein have any interest in this proposal or in the Contract to be entered into, if the award is made on us, that this proposal is made without any connection with any other person, firm or party likewise submitting a proposal is in all respects for and in good faith, without collusion or fraud.

Designation :

Printed Name :

Designation :

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